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Despite joint efforts between anti-drug forces of Vietnam and Cambodia, drug crime across their shared border has complicated in recent years. Traffickers also use Vietnam as a transit point for drug to be shipped to other countries. Meanwhile, some international trafficking rings also operate across the Vietnam — Cambodia border. The training course on drug investigative techniques and strategies is part of a memorandum of understanding signed at the 15th bilateral meeting at the ministerial level on anti-drug cooperation in HCM City in December Participants in the training course pose for a photo Photo: cand. Cambodian Prime Minister Samdech Hun Sen has suggested public security forces of Vietnam and his country strengthen collaboration in combating crimes in the coming time. An agreement to open four more pairs of auxiliary border gates has recently been signed between authorities of the southern province of Tay Ninh and its neighbouring Cambodian province of Svay Rieng.

Vietnam assists Cambodia to raise anti-drug capability

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Official websites use. Share sensitive information only on official, secure websites. Correspondence: Meeyoung O. Establishing positive network resources and rebuilding drug free networks are key components of recovery process for women with substance use disorder SUDs. Theory of planned behavior TPB posits that behaviors are determined by behavioral intentions, which are determined by three factors: attitude toward the behavior, perceived behavioral control, and subjective norms. Longitudinal data from American women with SUD who received treatment at three county-funded, women-only intensive treatment programs was utilized for the current study. Bayesian estimation path analyses indicated that attitude and abstinence self-efficacy at intake were not related to intention at the 6-month follow-up, but abstinence self-efficacy was directly related to substance use relapse by 12 months. Personal social network characteristics, number of treatment related persons in personal social network and sobriety support were significantly associated with intention at 6 months. The interaction between the numbers of treatment related persons and density was found on intention, suggesting that density strengthens the relationship between treatment related persons in network and intention. Intention to use substance was associated with relapse to substance use behavior. Our findings support that personal social network characteristics can be considered as subjective norms in the TPB model. Personal social network interventions focusing on rebuilding consistent social norms against drug-using behaviors may decrease intention to use substance, which will lead to abstinence. Keywords: Relapse to substance use, Substance abuse treatment, Personal social networks, Theory of planned behavior. Women use substances differently than men. Women are more likely to self-medicate with substance to cope with emotional, relational problems \[ 1 \]. In addition, women are more likely to suffer from substance abuse related problems such as unbalanced sex hormones, panic attacks, depression, and overdose, may have more drug cravings, and more likely to relapse after treatment \[ 3 \]. In spite of multiple resources available in substance use treatment, relapse to substance use is frequent \[ 4 \]. Relapse is the recurrence of substance use disorder SUD symptoms after a period of reduced substance use \[ 4 , 5 \]. While relapse can be a normal part of recovery process, for some substance, it can be very dangerous. Relapse rates may vary with its definition, study population, type of substance, and time since treatment. These rates are similar to the rates of relapse for other chronic diseases such as hypertension or asthma \[ 6 \], supporting that SUD should be treated as a chronic illness that distresses the entire body \[ 6 \]. Identification of factors associated with relapse risk among women with SUD is critical for the development of appropriate treatment programs for those at risk. Women are more influenced by the people in their networks during substance use or recovery than men \[ 10 \], experience more traumatic events that impact their interactions with their networks \[ 11 , 12 \]; and ted to have lower social support for recovery \[ 2 \]. Women are more likely to have a co-occurring mental disorder, and women with co-occurring mental and SUDs may have more difficulty in accessing and using recovery supports \[ 13 \], increasing the risk of substance use relapse \[ 14 \]. The theory of planned behavior TPB is a widely used social cognitive model of health-related behavior, including substance use \[ 15 , 16 \]. The TPB posits that attitudes, subjective norms, and perceived behavioral control predict intentions to engage in a behavior; and intentions and possibly perceived behavior control predict actual behavior \[ 17 \]. In addition, perceived behavioral control also conceptualized as self-efficacy is considered to affect behavior directly and indirectly through behavioral intention. The TPB has been widely used in explaining substance use behavior \[ 18 - 21 \], indicating that more positive attitudes and perceived norms to substance use, and lower efficacy to refuse substance use are related to greater intentions to use drugs, and those intentions in turn predict substance use behavior \[ 22 , 23 \]. Especially the subjective norm has been a weak predictor of intentions \[ 25 \], with multiple studies suggesting that the normative component within the TPB inadequately account for various ways that social influence can be exerted \[ 26 \]. Typically, for the last decade social norms are formed by observing and modelling the behavior of family members, peers and friends, and including PSN characteristics may reflect more diverse perspective of subjective norms in the TPB model \[ 27 \]. In fact, PSN characteristics have been shown to account for substance use behaviors \[ 14 , 28 - 30 \]. The existing research on the TPB of substance use behaviors is limited by use of cross-sectional or retrospective research designs \[ 31 , 32 \], compromising its internal validity. In predicting actual substance use behavior based on the TPB, a cross-sectional survey does not allow researchers to examine actual future behavior. In order to examine the relationship of the factors in TPB model in substance use behavioral change processes, this study utilized data from a prospective longitudinal research design. The present study examined the application of the TPB to understanding intentions and relapse of substance use over a month period in a sample of women with SUD. The primary goal of this study is that whether PSN characteristics can be considered as subjective norms in the TPB model. As illustrated in Figure 1 , we hypothesized that 1 attitude and abstinence self-efficacy would be directly related to substance use intention; 2 abstinence self-efficacy would be directly and indirectly related to substance use relapse via substance use intention; 3 PSN factors as subjective norm would be directly related to substance use intention; and 4 intention would be related to substance use behavior. In the present study, the sample was women who received substance abuse treatment from three county-funded, women-only treatment programs in Northern Ohio. Women were eligible to be included in the study if they were 18 years of age or older, had been in treatment for at least one continuous week, and had a diagnosis of substance dependence defined as a Diagnostic and Statistical Manual of Mental Disorders, 4th edition DSM-IV within the past 12 months of entry into the study for at least one substance, including alcohol. Participants with a known diagnosis of schizophrenia or who were taking medication prescribed for a major thought disorder were excluded \[ 33 \]. The study was reviewed and approved by the Case Western Reserve University Internal Review Board for the protection of human subjects. The study protocol, including signed written and informed consent at each follow up interview, was approved. A Certificate of Confidentiality was obtained from the Department of Health and Human Services to protect against the release of drug-related information. The data were collected over the course of a year: at one-week post treatment intake, and at 1, 6, and 12 months post-intake between October and May A total of women were enrolled in the study, and were eligible for follow up 5 were deceased, withdrew or too ill. The present analysis includes women, Those lost to follow up were more likely to report higher trauma symptoms at intake; no difference was found in race, age, dual disorder status, homelessness, legal involvement, employment, number of substances dependence, and duration of SUD \[ 34 \]. Complete demographic and clinical characteristics for the sample at intake are presented in Table 1. The women had 2. Since there is no standard scale offered to measure TPB constructs, the TPB measures were created for this study in accordance with the guidelines from Ajzen \[ 18 \]. Descriptive statistics of these variables are shown in Table 2. Using wording from the Individual Assessment Profile \[ 35 \], respondents were asked at the 12 month interview, whether and how often they had used any of 12 substances e. Respondents reported their frequency of substance use in the past 6 months as never 0 , 1—3 times per month 1 , 1—6 times per week 2 , and daily once or more times a day 3. Since intentions may be altered over time, it is suggested to measure the intention as closely as possible to the behavioral observation to obtain an accurate prediction \[ 18 \]. The variable was reverse-recoded, with higher scores indicating increased intentions to use the drugs or alcohol. Since the measure of behavioral intention to use substances is the frequency of attending support group meetings, this behavior is a proxy for behavioral intention. The attitude toward substance use was measured by adapting 9-item scale originally proposed by Joe et al. Items were reconstructed to measure attitude toward recognized problem of substance use e. Higher scores indicate greater negative attitudes against substance use behavior. The internal consistency of the attitude measure was 0. PSN characteristics, as subjective norms, were collected with computer-assisted interview using Egonet software \[ 38 , 39 \] by asking each respondent alter 1 25 alters e. As changes in network characteristics during and post treatment \[ 34 \], measurement at six months was considered more appropriate than the one at intake. Three items were designed to measure subjective norms toward substance use: network composition e. Network composition was assessed by the number of treatment related network persons, including professionals of substance use treatment and peers from treatment and step programs, with higher scores indicating more positive social norms against substance use in her network range from 0 to Network sobriety support was assessed using the number of network persons providing sobriety support e. The higher scores indicate greater perceived sobriety support to the respondent. Network density assesses the extent of cohesiveness, computed as the ratio of the number of present ties divided by all possible ties among network members. Higher scores indicate more densely connected network among network member range from 0 to 1. Since the influence of treatment related persons and sobriety support on intention may vary depending on the extent of cohesiveness \[ 40 \], two interaction terms, density by network composition and density by network sobriety support, were included to explore their relationships with substance use intention. Multicollinearity was assessed by examining variance inflation factor VIF ; no multicollinearity problems were detected as evidenced by low VIF values the highest VIF value was 1. Due to the use of a dichotomous variable substance use coded as 1 and non-use coded as 0 , Bayesian SEM estimation employed Makrov Chain Monte Carlo algorithm. This process automatically rescales a binary variable to run a probit model. Bayesian SEM does not provide the familiar chi-square index of model fit nor does it offer modification indices for valuable model refinement. Instead, posterior predictive P PPP values \[ 42 \] are provided to indicate model fit. Model fit is deemed good the closer the PPP is to 0. Bayesian statistics report a credible interval CI , instead of confidence interval. A CI is a range within which an unobserved parameter value falls with a particular probability and in the domain of a posterior probability distribution \[ 45 \]. Missing data were modeled using full-information maximum likelihood, which uses all available information from the observed data. Table 2 presents the correlations for all study variables included in the model. Although attitude and treatment related persons were not significantly correlated with the outcome, variables correlated with intention to use substance were correlated with the outcome. Overall, these correlations followed the expected pattern. Path analysis was performed to test the hypothesized model. As presented in Figure 2 , attitude and abstinence self-efficacy at intake and subjective norms at 6-month were specified to predict intention to use substance at 6 months, which in turn was modeled to predict relapse to substance use behavior at 12 months. Bayesian estimation indicated PPP value 0. Only standardized coefficients are reported Figure 2. Path diagram for predicting relapse to substance use over the month period. Standardized path beta coefficients regression weights. Path coefficient is significant at the 95 percent credible interval. The unbroken lines represent significant standardized coefficient in the model. Namely, the more cohesive network with more number of treatment related personale, the less intention to use substance. No other significant interaction i. The current study examined the utility of the extended TPB to explain relapse to substance use behaviors over a month period, investigating whether PSN factors as subjective norms affect intentions. Attitude and abstinence self-efficacy at intake were not related to intention to use substance at the 6-month follow-up, but abstinence self-efficacy was directly related to relapse to substance use at the month follow-up. PSN factors, number of treatment related persons and sobriety support available in PSN, were related to intention. Although density was not related to intention, its interaction with the number of treatment related persons explained intention. Namely, density strengthened the negative relationship between the number of treatment related persons in network and intention to use substance. The more densely connected network among network member, the less intention to use substance. Intention to use substance at 6 months was the strongest factor of relapse to substance use behavior at 12 months. Although the TPB had explained a wide range of health-related behaviors such as drinking, smoking, drug abuse, and aggressive behavior \[ 18 , 47 \], the TPB was considerably less predictive of behavior when a longitudinal research design, rather than a cross sectional design, was employed. The present study demonstrated the utility of the TPB in understanding relapse of substance use in the context of longitudinal follow-up, providing additional support for the TPB. The present study also demonstrates the role of additional normative variables such as the PSN component, structure, and support and the importance of considering interactions among normative variables in the TPB. The subjective norm construct has been generally a weak predictor of intentions \[ 25 \], calling for a need to expand the normative component \[ 19 \]. The current study has shown that, consistent with previous findings \[ 40 , 48 , 49 \], having more treatment related persons and more sobriety support in their network are associated with decreased substance use intention. Subjective norms, operationalized as PSN characteristics, may increase the explanation of intention over and above the other TPB variables. Sobriety support and treatment related persons in network were associated with decreased intention for the substance use; and intention was related to less likelihood of substance use. Although density moderated the impact of treatment related persons on intention, it did not moderate the impact of sobriety support on intentions. Higher density supported recovery intention when the network had many helpful persons physically surrounded in the network \[ 9 \]. Sobriety support from a qualified professional counselor or treatment related persons may provide more concrete and informative support than friends or family members. Given the particularly strong association between PSN variables and intention to use substance, PSN should be a target for prevention and intervention efforts. Although direct comparisons of relapse rates between studies are problematic because of the diversity of treatment settings, sample populations, and various follow-up intervals and definitions of relapse, our findings indicate that improving abstinence selfefficacy and PSN, the two main constructs of the TPB, could be promising targets for maintaining abstinence. There are still a few limitations to the current study. The generalizability of the present study is limited because of the use of a convenience sample of low income, inner-city women served by county service systems. However, given the prevalence of substance use behavior in this population, it is clearly different cultural and ethnic sample in need of further study. Although the current study employed a prospective design, the follow-up period was limited to 12 months; future studies should incorporate a longer follow-up to further examine the utility of TPB in longitudinal design. The current study also relied on the use of a self-report survey, subject to recall bias, and memory distortion. Finally, future research should also examine the role of social network services SNS and online based cybercommunity as subjective norms. PSN interventions e. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Investigation: HyunSoo Kim. Software: HyunSoo Kim. Supervision: Meeyoung O. Min, Doug Hyun Han. Validation: Meeyoung O. Visualization: HyunSoo Kim. Writing—original draft: HyunSoo Kim. As a library, NLM provides access to scientific literature. Psychiatry Investig. Find articles by HyunSoo Kim. Find articles by Meeyoung O Min. Find articles by Doug Hyun Han. Open in a new tab. Characteristic Value Race, African American Attitude problem recognition - 2. Abstinence self-efficacy Treatment related persons 0. Sobriety support 0. Density Intention to use substance Relapse to substance use behavior 0. Availability of Data and Material The data that support the findings of this study are available on request from the corresponding author. Conflicts of Interest The authors have no potential conflicts of interest to disclose. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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